You’re a middle-class mom with two kids, a mortgage, a fragile marriage, and an elderly parent to care for when you find yourself pregnant. You’re a sexually active college student and because of a condom failure you’re pregnant. You’re pregnant with a wanted child when you learn your fetus has a serious anomaly and probably can’t survive outside the womb. You are a rural woman with limited income who gets routine healthcare at a Planned Parenthood now threatened with closure.

Variations on stories like these abound. For all kinds of women, and their advocates, they are terrifying, as federal and state legislators continue gunning for Planned Parenthood and vehemently resisting female autonomy, privacy, and decision-making.

As a recent New York Times piece by the editorial board stated, “In its continuing assault on reproductive rights, the Trump Administration has issued potentially devastating changes to the nation’s nearly 50-year-old family planning program, Title X, which allows millions of women each year to afford contraception, cancer screenings, and other critical health services.”

To be clear, health clinics like Planned Parenthood have been barred from using federal funds for abortions, but they have been able to to offer non-federally funded abortions and other family planning services under one roof. Now the Department of Health and Human Services wants to make clinics that provide abortions navigate ridiculous regulations if they want to receive Title X funds. I mean ridiculous regs, like having separate entrances for abortion patients, or establishing an electronic health records system separate from their regular system. Providers will also be prohibited from making abortion referrals, or providing information that adheres to standards for “informed consent.”

In addition to threats at the federal level, more and more states are attempting to pass ridiculous anti-abortion laws, like requiring wider hallways or revamping janitor’s closets.

More Draconian is the unethical “domestic gag rule” that allows so-called “pro-life” staffers in Title X facilities to say a particular procedure doesn’t exist or to lie to patients about false risks of abortion.

As Dr. Leana Wen, the new president of Planned Parenthood, told The New York Times, “There will be many providers that will face an impossible decision: to participate in Title X and be forced to compromise their medical ethics, or to stop participating in that program,” a step that would lead to overwhelming demand for reproductive health care but not much in the way of supply to respond.

Since Roe v. Wade was decided in 1973, states have been constructing a maze of abortion laws that codify, regulate and limit whether, when and under want circumstances a woman can have an abortion, as the Guttmacher Institute points out. Major provisions to states laws, some on the books, other in litigation or defeated, include requiring that abortions be performed in a hospital or set gestational limits on abortion.

One example is the attempt to ban abortions when a faint heartbeat is detected, which can occur as early as six weeks, before a woman may know she is pregnant. Another is state restrictions on coverage of abortion in private insurance plans, and states allowing individual health care providers to refuse to participate in abortions. Some states mandate that a woman have counseling, including information on purported links between abortion and breast cancer, the ability of a fetus to feel pain, or long-term mental health consequences for the woman.

The Trump administration clearly wants to evict Planned Parenthood from the federal family planning program. It also hopes to ban abortion referrals. At the state level, early abortion bans called “heartbeat bills” are being proposed in several states. So far, five of them have advanced this legislation but every “heartbeat bill” passed to date has been overturned in state or federal court. With Judges Gorsuch and Kavanaugh on the Supreme Court, who know what will happen?

Five states have already passed preemptive “trigger laws” which would immediately ban abortion outright if Roe v. Wade is overturned.

Several abortion cases are currently in federal appeals courts or pending litigation in various states. Lawsuits are challenging such issues as required waiting periods, required ultrasounds, 15-week bans, admitting privileges, abortions for minors, and Medicaid coverage.

The situation, not only for women seeking their constitutional right to abortion, but for women – and men - seeking appropriate, quality, accessible, affordable reproductive health care ranging from preventive screening and contraception to treatment of sexually transmitted diseases, grows ever more dire as the Trump administration, and state legislators attempt to control what should be women’s private, personal decisions.

The irony is that rules rooted in anti-abortion (and anti-sex education) feelings threaten access to contraception, which prevents unwanted or unintended pregnancy and consequently increases health care costs in a nation where the cost of care is already skyrocketing. Can anyone explain why that makes sense?

More importantly, perhaps, can anyone fathom what would happen without Planned Parenthood?

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Elayne Clift writes about women, health, and social issues from Saxtons River, Vt.